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Defending a Nursing License in Texas

I recently posted an article about the basic regulatory scheme of a nurse-owned med spa. Failure to comply with the rules governing nursing as well as med spas in Texas can result in a board complaint. If a nurse is facing a complaint or investigation by the Texas Board of Nursing (BON), it is important to take immediate action, as the matter is a formal legal proceeding. Here is an overview of the general process for defending a nursing license in Texas.

1. Notification: The BON will notify the nurse in writing of the complaint or investigation. The notification will include information about the allegations, the nurse's rights, and the process for responding to the complaint. Any person may file a complaint, and no administrative filter exists to dismiss facially non-meritorious claims. Meaning, if a complaint is filed it will be undertaken.

2. Investigation: The BON will conduct an investigation into the allegations. The investigation may include gathering evidence, interviewing witnesses, and reviewing medical records or other documents related to the case. The nurse subject to the complaint may be asked to provided additional information or documentation.

3. Response: The nurse will have an opportunity to respond to the allegations and provide evidence in their defense. This response should be thorough, accurate, and timely.

4. Informal Settlement: Unlike a license defense proceeding for a physician, if the BON determines that the evidence is sufficient to support the allegations, it likely will not offer the nurse an opportunity to attend an informal settlement conference. The BON may be willing to mediate a claim, but it likely will not engage in an informal settlement conference.

5. Formal Hearing: If the case cannot be resolved through negotiation, the BON may schedule a formal hearing before an administrative law judge. The hearing will provide an opportunity for the nurse and the BON to present evidence and arguments in front of this neutral decision-maker. The case is tried at the State Office of Administrative Hearings (SOAH). The nurse will be able to conduct written discovery, depose witnesses, and file dispositive motions and other pleadings.

6. Decision: After the hearing, the administrative law judge will issue a decision. If the judge finds in favor of the nurse, the case will be dismissed. If the judge finds that the allegations are supported by the evidence, the nurse may face disciplinary actions such as a reprimand, probation, suspension, or license revocation.

7. Appeal: The nurse may appeal the decision to a higher court. The initial appeal is made to a state district court where a judge may sustain the SOAH decision or reverse it based on a substantial evidence standard. If unsatisfied at the district court level, a nurse can further appeal to the Texas Third Circuit Court of Appeals.

Just like physicians, nurses who own med spas cannot fail to ensure complete compliance with the BON rules as well as those governing the practice of medicine and med spas. License defense proceedings, like any legal action, are stressful and expensive and could result in disciplinary action. The best approach is to safeguard a hard-earned and valuable license by adhering to the applicable rules and regulations.

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